Hyperuricemia among patients with hypertension at Moi teaching and referral hospital, Eldoret, Kenya

Abstract

Hyperuricemia among Patients with Hypertension at Moi Teaching and Referral Hospital, Eldoret, Kenya. Background: Hypertension contributes to 9.4 million of the 17 million global cardiovascular diseases annually. Uric acid, a mediator of high blood pressure is an inexpensive easy-to-obtain indicator of cardiovascular risk (stoke, myocardial infarction and renal disease). Clinical characteristics associated with hyperuricemia include: Diabetes, dyslipidemia, hypertension, renal failure, obesity, age, gender and diuretic use. This study was conducted to determine the prevalence and risk factors of hyperuricemia among patients with hypertension in Moi teaching and Referral Hospital. Objective: To determine the prevalence of hyperuricemia and associated clinical characteristics among patients with hypertension at Moi Teaching and Referral Hospital. Methods: This cross sectional study conducted at MTRH medical outpatients’ clinic enrolled randomly patients with hypertension. Clinical (age, gender, stroke, body mass index, antihypertensive drugs and duration of illness) and laboratory (fasting lipid profile, blood sugar, uric acid and serum creatinine) data were collected. Data were keyed into Microsoft excel database and analyzed using STATA version 13 special edition, where descriptive statistics were summarized in tables and graphs. Significance tests such as the two-sample t-test for comparison of two normally distributed continuous variables, two-sample Wilcoxon rank sum test for non-Gaussian distributed continuous variables, and Pearson’s Chi Square test for categorical variables were used. Results: A total of 275 patients were enrolled; 182 (66% female). Mean age 54±12.5 years; mean Body Mass index 28.9±4.9 Kg/m2 and median duration of illness 6months. Prevalence of hyperuricemia was 44 %( 121/275): Males had a prevalence of 37.6 % (35/93) and females of 47.3 %( 86/182): A history of stroke were 29 (10.6%) and 42 (15.3%) had a history of diabetes. Most patients were on treatment for hypertension, 143 (52.4%) on diuretics, 154 (56.1%) were on calcium channel blockers, eighty four 30.6%, were using enalapril, 18.2% were on losartan. Thirty eight (13.8%), were on treatment for diabetes mellitus and 23 (8.4%) were on statins. Most patients had poor blood pressure control with more than 70% with Systolic Blood Pressure > 140 mm Hg, and > 50% had Diastolic Blood pressure>90 mm Hg. Dyslipidemia was prevalent among 248(90.2%), with majority 207 (75.3%) having elevated total cholesterol, 125 (45.5%) with elevated Low Density Lipoprotein. The median Glomerular Filtration Rate was 110.5 (IQR: 88.7, 122.7) ml/min per 1.73m2.There was a positive association between, high Body Mass Index (P=0.036), low Glomerular Filtration Rate (P<0.0001), dyslipidemia (p<0.0001) and hyperuricemia while use of calcium channel blocker and losartan was negatively associated. Conclusion: There is a high prevalence of hyperuricemia among patients with hypertension. The risk factors associated with hyperuricemia were high Body Mass Index, dyslipidemia, low Glomerular Filtration Rate and use of losartan. Recommendation: Screening for hyperuricemia should be done on patients with hypertension